HomeMy WebLinkAboutLA028277 PERMIT T
CITY OF LA~EVILLE PERMIT TYPE:
20195 HOLYOKE AVE. P.O. BOX 957 ~ `$U I LI? I NG
Permit Number:
_ Lakeville, Minnesota 55044-8012 C32~~~'~
' (612) 469-4431 ~ Date Issued:
O~i/28/94
SITE ADDRESS:
f XXXX CRYSTAL HILLS I?R
LOT; BLOCK: 2
CRYSTAL LAKE GOLF ESTATES 2ND A.I)I3ITION
PT OF SEc~ 5 Tt~td 1241 R ~G
DESCRIPTION:
PiTI~P HOUSE FOR I RR I G
Bui lc~ins~ Permit Type RES-AI.)rN\RFPA.IR.S
Build9.ng Work Type NEW
UBC Qrcupancy N-1
Construction Type V-N
honing R-2
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REMARKS:
FEE SUMMARY:
VALt1AT I ON $250
Base Fee X15,00
Surcharge ~
, 50
Total Fee X15.50
I. CONTRACTOR: OWNER:
- Applicant - ST, LIC
ROTTLUND CO INC 1335 ROTTLt3ND CO INC
2~i81 LONGLAKE RD XXX
ROSEV I LLE SIN 55113 XXK ESN
t,~12) 571-0304
I IIERF'liY A.CTREE THAT TI-IE Wi~RK ~'t~R WI3 I t=.I~ THIS PERK i T I I SSt~ED SHA1,Ia RE FEF.-
FOkMED AGC:OKT) I NG TC? : C 1) THE A FPkC3VED FLANS ANP SPED I F I C;AT I C1~1S ; T1~E
TJ I LT) I NG CC)DF .
APPI, I GABLF CITY QRT) I NANGES ! AND CCIPES ; ANT) , ~ 3) T MN STATE I3
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ISSUED BY: GNATURE
` ~ ~ $UILDING PERMIT APPLICATION ~ "
~ RESIDENTIAL CONSTRUCTION
CITY OF LAKEVILLE ~v~
DEPARTMENT r
BUILDING INSPECTION
20195 HOLYOKE AVENUE, P.O. BOX 957 ~
LAKEVILLE, MINNESOTA 55044
(612) 469-4431
Date: ~ ~ ~ ~ _ ~ School istrict #
n ~ ~f3 r `l~
Job Site Address: a ~ ~ ~g ~ ~ 5 ~ ~
, ~ ~
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Legal Description: Lot Block~~Subdivision:
Applicant: Owner or Contractor (circle one) ` f~~~~~~h
Owner : ~ t "r`~" i~~''L^ c ~ Phone : ~ ~ ~ ~
~
Street Addre s: City_ Zip
• ~ City I.D.# F
Contractor. FFF~~4 J~~ Contr. No. Phone:
Street Address: ~ ~ ! ~ ' City: r~t ~ Zip 5--~~~ 3
se Describe in Detail ~ ~ ~ M'fr' ` ~`u
rrepesel U ( )
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Valuation of work (excluding land) :
Interest earnings on the escrow accounts, if any, are retained by the City
to offset the administrative costs associated with processing the escrow
application and refund.
I hereby apply for a building permit and I acknowledge that the
information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the city and with the state
building code; that I understand this is not a permit and work is not to
start without a permit; and that a work will be in accordance with the
approved plan. -
' Applicants igna ure Date: ~
~ f ( ~i
~ OFFICE USE
Class of Work: New (81) Addition (82) Repair (83)
Demolish (84) Rep ce (,~35j, Alter/Remodel (86) Move (87)
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APProved by : t ~ ~ PID
` Census Code •
Date • t~ ~ ~ ' Local Code : ~
SAC Code •
Comments : City Valuation: ~
~
Resolution Number:
Planning Case
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RESIDENTIAL BUILDING PERMIT APPLICATION PAGE 2
OFFICE USE
BUILDING PERMIT TYPE:
Single Family Dwelling (10) Construction Type
2 Family Dwelling Units (20)
Townhouse Units (30) ~ Standpipes
Multi-Family Apartments (50)
Mobile Home Installations (60) Sprinklers
Mobile Home repairs (61)
Gauges (70) Tax Property
_',piccessory Buildings (71)
~-Residential (Addn/Remodel) (75) Owner: Public PYivate
Commercial Bldgs-New (80) ~
Commercial Bldgs (Addn/Remodel) (81) UBC Occupancy
Industrial Bldgs-New (85)
Industrial Bldgs (Addn/Remodel) (86) 1~ ~~Zoning
Tax Exempt (Addn/Remodel) (89)
Tax Exempt Buildings (90)
Swimming Pools (91) Watershed District
Signs/Billboards (92)
Fences (93) Special City Zones
Buildings Moved (94)
Buildings Demolished (95)
Foundations Only (96)
Grading (97)
Miscellaneous (98)
REQUIRED INSPECTIONS:
FOOTING (61) FRAMING (62) INSULATION (63) FINAL(65)
FOUNDATION (67) FIREPLACE (68) SITE (71) OTHER (70)
PERMIT FEE: DRAINTILE ( 7 5 )
PERMIT FEE: $ / -
PLAN CHECK: $
SURCHARGE : $ ~ ; `
SAC: $
WATER HOOKUP UNIT: $
SEWER HOOKUP UNIT: $
LANDSCAPE ESCROW $
TREE ESCROW
OTHER: $
TOTAL: $ ~ ~ j c.,
2422 E~#erprlse Oriva
'K Mendoty Heights, I~tN S$12[l
~ ~612~ ~Si,--1 ~i4 ~1~1C; 'i-~
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' ~ert~fie~~k~ t~fi purvey fc~r:
THE ~tt3TTL1JND? G+PANY
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wE IiEREBY CERTIFY THA? THIS ~111~UEY, PLAN OR REPORT ilt~S PREPA~2ED
BY #~IE, t3R Ul~tDER MY DIRECT SUPERVISIQN AID THAT I AM Dl1LY
RE6I5TE12ED E.AIiD SURVEY+Dft 1JHDER THE IAMS~ t~F TttE STATE O~
MIi~NE50TA, Ot~TEQ THIS d ` ~ DAY ER: L,C rt,.~C .D.,
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S Ea IDLER ~ RI P.A_
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30HM C. E. L.S.,REG.#x9825